the four cornerstones of good health - laura james, nd · •use of body’s innate healing power...
TRANSCRIPT
The Four Cornerstones of Good Health Team Survivor Northwest Annual Retreat January 25-27, 2013
Laura A. James, ND, FABNO Red Cedar Wellness Center, Bellevue, WA www.redcedarwellness.com 425.451.0999
Today’s agenda
• Integrated Medicine Perspective on Cancer
• The Four Cornerstones for Good Health
•Diet
• Exercise
• Sleep
• Stress Management
• Thriving Beyond Survivorship
Laura A. James, ND, FABNO
Integrated Medicine for Cancer
What is Integrated Medicine for Cancer? • Science-based holistic approach treats body,
mind, spirit
• Use of body’s innate healing power
• Use of natural substances to promote healing
• Herbs, nutrition, supplements, physical therapies, natural drugs, counseling, homeopathy and biofeedback
• Pharmaceutical drugs if needed
• Complementary to and supportive of conventional treatment for cancer Laura A. James, ND, FABNO
What is Integrated Medicine for Cancer? • Symptom management during treatment
• Nutritional and metabolic support
• Restoration of health post active treatment
• Provide the tools for proactive survivorship
• Focus on prevention
Laura A. James, ND, FABNO
Integrated Medicine Use by Oncology Patients
Up to 83% of cancer patients use CAM nationally (1) •Women more likely to use than men • Breast cancer patients more likely to use CAM
therapies
70.2% of cancer patients use CAM in western WA (2)
•Nutritional, massage, herbs, spiritual, relaxation, imagery, exercise, lifestyle, diet
(1) Richardson MA, Sanders T, Palmer JL, Greisinger A, et al. Complementary/alternative medicine use in a comprehensive cancer center and the implications for oncology. Journal of Clinical Oncology 2000;18(13):2501-2504
(2) Patterson RE,Neuhouser ML et al. Types of Alternative Medicine Used by Patients with Breast. Colon, or Prostate Cancer: Predictors, Motives,
and Costs. Journal of Alternative and Complementary Medicine 2002:8 (4):477-485.
Laura A. James, ND, FABNO
Integrated Medicine Approach
• During active treatment: emphasize QOL, decrease side effects and disease symptoms, support recovery
• Post active treatment: restore health, manage late effects of treatment, prevent recurrence, reduce risk, emphasize QOL
• Utilize integrated medicine specialists, counselors, nutritionists, physical therapists, fitness trainers, and continue routine screenings and labs
• Turn surviving into THRIVING
Laura A. James, ND, FABNO
The Four Cornerstones
The Four Cornerstones
•Diet
•Exercise
•Sleep
•Stress Management La
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Diet
• Balanced, whole foods diet
• Top Ten cancer-fighting foods
• Mediterranean/low glycemic index foods
• Greens drinks
• Green tea
• Limit alcohol
• Improve digestion and elimination
• Identify food sensitivities
• Balance hormones, neurotransmitters, blood sugar
Laura A. James, ND, FABNO
Balanced Whole Foods Diet
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Balanced Whole Foods Diet
• WHEN you eat is as important as WHAT you eat
• Blood sugar regulation
• Six small meals daily of carbohydrate and protein
• Never a carbohydrate alone!
• Fruit is deceiving…Glycemic Index
• Organic meat and dairy
• Organic produce for the things that matter—see “The Dirty Dozen” and “The Clean 15”
• “Top Ten Cancer Fighting Foods”
• Eat a rainbow!
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Balanced Whole Foods Diet
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Balanced Whole Foods Diet
• Websites for more information:
• http://www.hsph.harvard.edu/nutritionsource/
• http://glutenfreegirl.com/
• http://www.ewg.org/
• http://pccnaturalmarkets.com
• http://wholefoodsmarket.com
• Cynthia Lair at http://cookusinterruptus.com and http://cynthialair.com
• Tom Malterre at http://wholelifenutrition.net
• Michael Pollan at http://michaelpollan.com
• “Forks over Knives” at http://forksoverknives.com
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Exercise
• Daily movement
• Calming, restorative movement like yoga, Tai Chi
• Cardiovascular benefits
• Manage excess weight/abdominal fat
• Helps to regulate hormones and neurotransmitters
• Helps with quality sleep
• Combats chronic health issues
• Feels great!
Laura A. James, ND, FABNO
Exercise
• Weight loss reduces breast ductal fluid estrogens in obese postmenopausal women: a single arm intervention pilot study. Nutr J. 2012 Dec 5;11:102.
• Impact + resistance training improves bone health and body composition in prematurely menopausal breast cancer survivors: a randomized controlled trial. Osteoporos Int. 2012 Sep 21.
• Effect of combination exercise training on metabolic syndrome parameters in postmenopausal women with breast cancer. J Cancer Res Ther. 2012 Apr-Jun;8(2):238-42.
• Reduced-calorie dietary weight loss, exercise, and sex hormones in postmenopausal women: randomized controlled trial. J Clin Onc. 2012 Jul 1;30(19):2314-26.
• Effects of a caloric restriction weight loss diet and exercise on inflammatory biomarkers in overweight/obese postmenopausal women: a randomized controlled trial. Canc Res. 2012 May 1;72(9):2314-26.
• Physical activity reduces breast cancer risk in African American women. Ethn Dis. 2011 Autumn;21(4):406-11.
• A qualitative exploration of the impact of yoga on breast cancer survivors with aromatase inhibitor-associated arthralgias. Explore. 2012 Jan-Feb;8(1):40-7.
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Exercise
• The NIH Obesity Education Initiative Expert Panel: caloric deficit of 500–1000 kcal/day + 45 minutes of moderate-intensity physical activity.
• The Institute of Medicine : 1 hour/day of moderately-intense physical activity + caloric deficit.
• US Department of Agriculture: 1 hour of moderate-to-vigorous intensity exercise on most days of the week, without exceeding caloric intake requirements.
• The US Center for Disease Control : at least 30 min/d of moderate-intensity exercise most days of the week while maintaining sensible portion sizes.
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Exercise
• American College of Sports Medicine: 150 – 250 min/wk + moderate caloric restriction.
• U.S. Department of Health and Human Services Physical Activity Guidelines Committee: exercise up to 60 min/d.
• Effect of diet and exercise, alone or combined, on weight and body composition in overweight-to-obese post-menopausal women. Obesity. 2012 August; 20(8): 1628–1638.
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Exercise
• Moderate intensity exercise is 60-70% of maximum heart rate.
• Moderate to vigorous exercise is 70-85% of maximum heart rate.
• Quick and Dirty way to calculate your maximum heart rate:
• 220 – age = MHR
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Sleep
• Lifestyle: good sleep hygiene, exercise, healthy diet, limit stimulants, stress management!
• Eight hours nightly
• Herbs: valerian, hops, passion flower, kava, skullcap, chamomile, lavender, lemon balm, oats
• Supplements: calcium, magnesium, inositol
• NT/Hormones: melatonin, 5HTP, GABA
Laura A. James, ND, FABNO
Sleep
• Sleep duration and incidence of colorectal cancer in postmenopausal women. Br J Cancer. 2013 Jan 15;108(1):213-21.
• Effect of mindfulness-based stress reduction on sleep quality: Results of a randomized trial among Danish breast cancer patients. Acta Oncol. 2013 Feb;52(2):336-44.
• Sleep Disturbance and Incidence of Thyroid Cancer in Postmenopausal Women The Women's Health Initiative. Am J Epidemiol. 2013 Jan 1;177(1):42-9.
• Decreased Health-Related Quality of Life in Women With Breast Cancer Is Associated With Poor Sleep. Behav Sleep Med. 2012 Mar 16.
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STRESS
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What is Stress?
• Physiological stressors
• Injury, illness
• Adolescence, pregnancy, post-partum, menopause
• Environmental pollutants, pesticides, pollen, climate
• Medications, substances, other chemicals
• Exercise, dieting, poor nutrition
• Mental/Emotional stressors
• Relationship/Family issues
• Financial/Work issues
• Personal issues
• Mental illness
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What is Stress?
• Stress activates the SNS, reduces influence of the PNS
• Physiological effects • Increased heart rate, blood pressure
• Constricted blood vessels
• Decreased digestion
• Enlarged airways
• Hormone and Neurotransmitter fluctuation
• Mental/Emotional effects • Heightened arousal (vigilance) and clarity
• Depression, irritability
• Fatigue, insomnia
• Confusion and memory loss
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Normal Stress
• Healthy response is activation of SNS (fight-or-flight)
• Recovery period with PNS (rest-and-digest) predominance
• Stress + Adequate Recovery = normal life stress
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Chronic Stress
• Long-term stress from unresolved issues elicits unhealthy physiological response, which can lead to mental/emotional adaptation
• Over-activation of SNS without PNS recovery
• Can result from one major stressor (i.e., death in family, moving, etc)
• Combination of minor stressors can produce major alarm reaction
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Chronic Stress
Alarm Reaction
Threshold at which alarm reaction is triggered
Minor
Stress
Major
Stress Minor
Stress
Minor
Stress
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Biochemicals
Neurotransmitters:
• Dopamine
• Acetylcholine
• GABA
• Serotonin
Cytokines:
• IL series
• CRP
• TNF-a
Hormones:
• Cortisol
• Insulin
• Thyroid hormone
• Estrogen
• Progesterone
• Testosterone
• DHEA
• Epinephrine
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Biochemicals
• Adrenal Glands sit on top of the kidneys
• Produce hormones: aldosterone, catecholamines, cortisol, sex hormones
• Affected by stress
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Adrenal Glands: Healthy Stress
• Balanced output of hormones
• Regeneration time of glands and hormone stores in PNS state
• Hormones available to body when needed
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Adrenal Glands: Chronic Stress
• Continued stress reduces adrenal output and impairs sensitivity of cell receptors to hormones
• Body adapts to chronic level of stress, and produces less of an alarm reaction when necessary
• Result of chronic stress is body breakdown and degenerative disease
• Other hormones can be affected
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Physiological Effects of Chronic Stress • Disrupts HPA axis, interferes with sleep, creates cycle of pain
and fatigue
• Decreases immunity, is anti-growth, anti-reproductive
• Creates hormone and neurotransmitter imbalance, depression, insomnia, insulin resistance, obesity, systemic inflammation, pain, and brain atrophy
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Stress and Cancer
• Stress alters biochemical balance of body and mind, which can alter prognosis
• Stress hormones can increase systemic inflammation and insulin balance, which are cancer promoters
• Good stress management techniques can help during diagnosis, treatment, & recovery, and helps with prevention of secondary cancers!
Stress Management Essential Tools for Cancer Survival
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Healthy Response to Stress
• Change your attitude!
• Get at least 8 hours of sleep nightly
• Rest and relax! Engage PNS, turn off SNS
• Eat a whole foods diet
• Daily exercise
• Take supplements if necessary
Stress Management
• Stress alters body’s biochemical balance and can alter prognosis
• Stress hormones systemic inflammation and influence insulin balance, which are cancer promoters
• Good practices can help whatever phase you’re in!
Laura A. James, ND, FABNO
Benefits of Stress Management • Immune function
• Mood & emotive capacity
• Pain
• Side effects of chemo
• Anticipatory n/v
• Anxiety
• Faster recovery post op
• Normalize cortisol rhythms
• Better sleep
Laura A. James, ND, FABNO
Supplements for Stress
• B vitamins, especially B5, B6, choline, inositol
• Theanine
• GABA
• Zinc, vitamin C
• Calcium and magnesium
• Omega 3 fatty acids
• Licorice, eleuthrococcus
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Biofeedback
• Use of monitoring tools to become aware of unconscious and automatic physiological processes
• Learn to control process
• Generalize control to all areas of life
• Measure temperature, heart rate, respiration, muscle contraction, brain waves
• Proven efficacy for myriad conditions
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Uses for Biofeedback
• Stress Management
• Anxiety
• Asthma
• ADHD
• Fatigue
• Hypertension
• Insomnia
• Irritable Bowel Syndrome
• Migraines
• Chronic Pain
• PMS
• Poor Muscle Control
• Raynaud’s Disease
• Optimum Athletic Performance
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Benefits of Biofeedback
• Increased awareness of body
• Increased feeling of control over symptoms
• Improved understanding of mind-body relationship
• Reduced stress, pain, and tension
• Safe, non-invasive, effective, cost-efficient therapy
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Today’s Exercises
• Diaphragmatic Breathing
• Autogenics Training
• Heart Rate Variability
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Heart Rate Variability
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Wellness Concerns for Survivorship • Manage late effects of treatment
• Prevent secondary recurrence of cancer
• Improve quality of life
• Nutritional and metabolic support
• Physical activity
• Quality sleep
• Stress management
• Survivorship care planning
Laura A. James, ND, FABNO
Integrated Medicine Treatment Goals Complementary cancer
care
Modulate immune system
Stress management
Balance neurotransmitters and hormones
Rebuild adrenal glands
Improve sleep
Daily exercise
• Address depression and mood changes
• Address cardiovascular health and obesity
• Prevent Metabolic Syndrome
• Mediterranean/low GI diet
• Correct digestive problems
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Thrivorship
Cancer Survivorship
Physical Well-being
Psychological Well-Being
Social Well-being
Spiritual Well-being
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WEBSITES www.mskcc.org - Memorial Sloan Kettering Cancer Center, select herbs www.naturaldatabase.com - Natural Medicine Comprehensive Database www.naturalstandard.com - Natural Standard www.cancer.gov - National Cancer Institute www.breastcancer.org - up to date breast cancer information www.integrativeonc.org - SIO www.oncanp.org – OncANP www.cancer.org – ACS www.cancercare.org – Cancer Care www.livestrong.org – Lance Armstrong Foundation www.komen.org – Susan G. Komen Foundation www.lbbc.org – Living Beyond Breast Cancer www.thewellnesscommunity.org – The Wellness Community www.oncolink.org – Moving Beyond Breast Cancer video www.her2support.org – for HER2 positive survivors www.nueva-vida.org – for Latinas with cancer
Laura A. James, ND, FABNO
Q & A
Laura A. James, ND, FABNO Red Cedar Wellness Center 1601 116th Avenue NE Bellevue WA 425.451.0999 www.redcedarwellness.com